Analysis of Risk Factors for Diabetic Foot Ulcer in RSUP Sanglah Denpasar.
THE 1ST UDAYANA INTERNATIONAL NURSING CONFERENCE
66. Formation Of Mental Health Alert Village (DSSJ) Using The Application Community
Mental Health Nursing (CMHN) Overcoming Symptoms Of Recurrence In Patients
With Mental Disorders In Puskesmas II East Denpasar
Ni Made Dian Sulistiowati, , Made Oka Ari K, KadekEka S, KomangMenik Sri K ...... 79
67. Validation Of The Dutch Eating Behaviour Questionnaire For Children (DEBQ-C). A
Preliminary Results
Francisca Shanti Kusumaningsih, Luh Mira Puspita .................................................... 80
68. The Influencing Factors Of Complete Antenatal Care (K4) In Puskesmas Kuala Behe
Kalimantan Barat
Sylvianingsih, IkaWidiAstuti, Indah Mei Rahajeng ....................................................... 81
69. Analysis Risk Factors For Diabetic Foot Ulcer In RSUP Sanglah Denpasar
Desak Made Widyanthari, Ni LuhPutu Eva Yanti ......................................................... 82
70. The Experience Of Sasak Teenage Mother In Childbirth
IkaWidiAstuti, BaiqFitria S, Suratiah ............................................................................ 83
71. Relationship Workload Nurses With Completeness Nursing Documentation In Angsoka
Room, General Hospital Sanglah
Ida Ayu Sri Utamawati,KomangAyuMustriwati, MenikKomang Sri ............................. 84
72. Pattern
Servical Cancer Detection As Preventif
Effort Of Woman
Reproductif
Problems In Primary Center Care Of Surabaya
Ni Ketut Alit A, Esti Yunitasari, Mira Triharini, Tiyas Kusumaningrum, Retnayu
Pradanie ......................................................................................................................... 85
73. The Determinant Of The Implementation Of Nursing Ethical Principles
Ni Putu Emy Darma Yanti, Hanny Handiyani, dan Kuntarti ........................................ 86
74. Occupational Health Study Of Woman Porters In Badung Market
PutuAyuSaniUtami, IkaWidiastuti, Francisca Shanti Kusumaningsih, Ni LuhPutu Eva
Yanti ............................................................................................................................... 87
75. Cader As A “Pilar” To Increase Family’s Ability To Manage The Health Of The
Elderly With Uric Acid Problem In CisalakPasar District Depok Indonesia
PutuAyuSaniUtami ......................................................................................................... 88
76. Nurses Position Analisys When Performing Burns Care In Burn Unit Sanglah General
Hospital Using Ovako Working Analysis System (Owas) And Rapid Entire Body
Assessment (Reba) And Rapid Upper Limb Assessment (Rula) Tools
I KadekSaputra .............................................................................................................. 89
ix
THE 1ST UDAYANA INTERNATIONAL NURSING CONFERENCE
ANALYSIS RISK FACTORS FOR DIABETIC FOOT ULCER IN RSUP SANGLAH
DENPASAR
Desak Made Widyanthari1), Ni Luh Putu Eva Yanti2)
1
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
2
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
Email: desakwidyanthari@yahoo.com
Abstract
Diabetes Mellitus (DM) can develop many various complications, both macrovascular and
microvascular. Diabetic Foot Ulcer (DFU) is a common complication in diabetic patients.
Injuries and other problems in the feet is a major cause of morbidity, disability and mortality.
Nurse is responsible to identify the risk factors of DFU so that the incidence of DFU can be
prevented. This study aimed to determine the most influence factors on DFU incidence in
RSUP Sanglah Denpasar. This study design was a case control study with 80 samples i.e. 40
DM patients with ulcer and 40 patients with non-ulcer. Multivariate analysis using multiple
regression logistic was employed. From the total nine variables being studied only the history
of recurrent ulcer or amputation variable that is statistically proven to affect the DFU (OR =
8.5; 95% CI: 2.1 - 33.5). Meanwhile, other variables do not prove to be statistically affect the
DFU (the sensory neuropathy, the motor neuropathy,autonomic neuropathy, sex, foot care ,
history of DM, age and blood glucose levels). 54% the incidence of DFU influenced by
factors studied, while 46% is influenced by other factors. It is reccommended that for a nurse to
provide health education foot care, particularly preventive measures in clients who have a
history of previous ulcer.
Keywords: risk factors, diabetic foot ulcer
82
Analysis of Risk Factors for Diabetic Foot Ulcer in RSUP Sanglah Denpasar
Desak Made Widyanthari1), Ni Luh Putu Eva Yanti2)
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
Telp: 0361-222510
desakwidyanthari@yahoo.com
2
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
1
Abstract
Diabetes Mellitus (DM) can develop many various complications, both macrovascular and microvascular.
Diabetic Foot Ulcer (DFU) is a common complication in diabetic patients. Injuries and other problems in the
feet is a major cause of morbidity, disability and mortality. Nurse is responsible to identify the risk factors of
DFU so that the incidence of DFU can be prevented. This study aimed to determine the most influence factors
on DFU incidence in RSUP Sanglah Denpasar. This study design was a case control study with 80 samples i.e.
40 DM patients with ulcer and 40 patients with non-ulcer. Multivariate analysis using multiple regression
logistic was employed. From the total nine variables being studied only the history of recurrent ulcer or
amputation variable that is statistically proven to affect the DFU (OR = 8.5; 95% CI: 2.1 - 33.5). Meanwhile,
other variables do not prove to be statistically affect the DFU (the sensory neuropathy, the motor
neuropathy,autonomic neuropathy, sex, foot care , history of DM, age and blood glucose levels). 54% the
incidence of DFU influenced by factors studied, while 46% is influenced by other factors. It is reccommended
that for a nurse to provide health education foot care, particularly preventive measures in clients who have a
history of previous ulcer.
Keywords: risk factors, diabetic foot ulcer
Introduction
Nowadays diabetes mellitus (DM) became one of the chronic diseases worldwide wich
prevalence increasing every year. This condition can occur due to sedentary lifestyle.
According the IDF atlas of 2013, the number of diabetic patients in the world has reached
382 million people, and its prevalence is expected to rise 55% to 592 million people by the
year 2035. Indonesia ranks seventh after China, India, USA, Brazil, Russia and Mexico to 10
major countries of DM patients with age 20-79 years (IDF, 2013).
If DM is not well handled, it will lead to various complications, both macrovascular and
microvascular. One complication in diabetic patients are diabetic foot ulcers. The injuries and
other problems in the feet is a major cause of morbidity, disabilit, mortality and if not
handled properly will caused an amputation.
The prevalence of foot ulcers vary in some populations. Neuropathy, deformity, high plantar
foot pressure, poor glucose control, duration of diabetes and age men are more at risk for
diabetic ulcers (Frykberg, 2002). Neuropathy will inhibit signal, stimulation or disruption of
communication in the body that allows individuals are not aware of the dangers on foot.
Diabetic foot neuropathy may experience sensory, motor and autonomic (Soegondo,
Soewondo & Subekti, 2013). Muller et al (2002) also pointed out that 23% of patients with
ulcers also had a history of ulcers or previous amputations.
The risk of diabetic ulcers in the elderly due to a decrease in the physiological functions of
the body due to aging processes which resulted in a decrease in secretion or insulin resistance
that affects the body's ability to control blood glucose levels. Particularly diabetic ulcers
occur in diabetic patients with ≥ 10 years of age due to uncontrolled glucose levels that
enable the emergence of microvascular and macrovascular complications (Hastuti, 2008).
Another factor affecting the incidence of diabetic ulcers are maladaptive behavior that
includes less obedient in doing injury prevention, testing and treatment feet (Lypsky et al,
2004). Foot care is one of the primary prevention efforts in the management of diabetic foot
ulcers which aims to prevent injury. This foot care that includes; I check my feet, cut nails
properly, check the proper footwear and memebersihkan even check the inside of shoes
before use.
The nurse as health care team is responsible for being able to doing early detection the risk
factors so the incidence of diabetic ulcers diabetic ulcers or amputations can be prevented.
Design
This research is case control design. The independent variable of this research consisted of
several risk factors ; gender, age, duration of diagnosed diabetes, blood glucose control,
previous ulcer history, sensory neuropathy, motor neuropathy, autonomic neuropathy and
foot care. The dependent variable is the incidence of diabetic foot ulcers. These samples
included 80, consisting of 40 control group and 40 groups of cases. In the case group, the
inclusion criteria are DM patients who experience diabetic foot ulcers in the SeptemberOctober 2015, willing to become respondents.. In control group the inclusion criteria are :
DM patients who did not have diabetic foot ulcers in the September-October 2015 and
willing to become respondents. The exclusion criteria for both case and control group are
patients who experienced a below knee amputation and loss of consciousness
The study was conducted at the Outpatient Interna Diabetic Centre and Outpatient Clinic
Surgery RSUP Sanglah Denpasar.
Result
1) Characteristic of respondent
The majority of respondents are male, aged
66. Formation Of Mental Health Alert Village (DSSJ) Using The Application Community
Mental Health Nursing (CMHN) Overcoming Symptoms Of Recurrence In Patients
With Mental Disorders In Puskesmas II East Denpasar
Ni Made Dian Sulistiowati, , Made Oka Ari K, KadekEka S, KomangMenik Sri K ...... 79
67. Validation Of The Dutch Eating Behaviour Questionnaire For Children (DEBQ-C). A
Preliminary Results
Francisca Shanti Kusumaningsih, Luh Mira Puspita .................................................... 80
68. The Influencing Factors Of Complete Antenatal Care (K4) In Puskesmas Kuala Behe
Kalimantan Barat
Sylvianingsih, IkaWidiAstuti, Indah Mei Rahajeng ....................................................... 81
69. Analysis Risk Factors For Diabetic Foot Ulcer In RSUP Sanglah Denpasar
Desak Made Widyanthari, Ni LuhPutu Eva Yanti ......................................................... 82
70. The Experience Of Sasak Teenage Mother In Childbirth
IkaWidiAstuti, BaiqFitria S, Suratiah ............................................................................ 83
71. Relationship Workload Nurses With Completeness Nursing Documentation In Angsoka
Room, General Hospital Sanglah
Ida Ayu Sri Utamawati,KomangAyuMustriwati, MenikKomang Sri ............................. 84
72. Pattern
Servical Cancer Detection As Preventif
Effort Of Woman
Reproductif
Problems In Primary Center Care Of Surabaya
Ni Ketut Alit A, Esti Yunitasari, Mira Triharini, Tiyas Kusumaningrum, Retnayu
Pradanie ......................................................................................................................... 85
73. The Determinant Of The Implementation Of Nursing Ethical Principles
Ni Putu Emy Darma Yanti, Hanny Handiyani, dan Kuntarti ........................................ 86
74. Occupational Health Study Of Woman Porters In Badung Market
PutuAyuSaniUtami, IkaWidiastuti, Francisca Shanti Kusumaningsih, Ni LuhPutu Eva
Yanti ............................................................................................................................... 87
75. Cader As A “Pilar” To Increase Family’s Ability To Manage The Health Of The
Elderly With Uric Acid Problem In CisalakPasar District Depok Indonesia
PutuAyuSaniUtami ......................................................................................................... 88
76. Nurses Position Analisys When Performing Burns Care In Burn Unit Sanglah General
Hospital Using Ovako Working Analysis System (Owas) And Rapid Entire Body
Assessment (Reba) And Rapid Upper Limb Assessment (Rula) Tools
I KadekSaputra .............................................................................................................. 89
ix
THE 1ST UDAYANA INTERNATIONAL NURSING CONFERENCE
ANALYSIS RISK FACTORS FOR DIABETIC FOOT ULCER IN RSUP SANGLAH
DENPASAR
Desak Made Widyanthari1), Ni Luh Putu Eva Yanti2)
1
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
2
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
Email: desakwidyanthari@yahoo.com
Abstract
Diabetes Mellitus (DM) can develop many various complications, both macrovascular and
microvascular. Diabetic Foot Ulcer (DFU) is a common complication in diabetic patients.
Injuries and other problems in the feet is a major cause of morbidity, disability and mortality.
Nurse is responsible to identify the risk factors of DFU so that the incidence of DFU can be
prevented. This study aimed to determine the most influence factors on DFU incidence in
RSUP Sanglah Denpasar. This study design was a case control study with 80 samples i.e. 40
DM patients with ulcer and 40 patients with non-ulcer. Multivariate analysis using multiple
regression logistic was employed. From the total nine variables being studied only the history
of recurrent ulcer or amputation variable that is statistically proven to affect the DFU (OR =
8.5; 95% CI: 2.1 - 33.5). Meanwhile, other variables do not prove to be statistically affect the
DFU (the sensory neuropathy, the motor neuropathy,autonomic neuropathy, sex, foot care ,
history of DM, age and blood glucose levels). 54% the incidence of DFU influenced by
factors studied, while 46% is influenced by other factors. It is reccommended that for a nurse to
provide health education foot care, particularly preventive measures in clients who have a
history of previous ulcer.
Keywords: risk factors, diabetic foot ulcer
82
Analysis of Risk Factors for Diabetic Foot Ulcer in RSUP Sanglah Denpasar
Desak Made Widyanthari1), Ni Luh Putu Eva Yanti2)
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
Telp: 0361-222510
desakwidyanthari@yahoo.com
2
Nursing Study Program, Faculty of Medicine, Udayana University Denpasar
1
Abstract
Diabetes Mellitus (DM) can develop many various complications, both macrovascular and microvascular.
Diabetic Foot Ulcer (DFU) is a common complication in diabetic patients. Injuries and other problems in the
feet is a major cause of morbidity, disability and mortality. Nurse is responsible to identify the risk factors of
DFU so that the incidence of DFU can be prevented. This study aimed to determine the most influence factors
on DFU incidence in RSUP Sanglah Denpasar. This study design was a case control study with 80 samples i.e.
40 DM patients with ulcer and 40 patients with non-ulcer. Multivariate analysis using multiple regression
logistic was employed. From the total nine variables being studied only the history of recurrent ulcer or
amputation variable that is statistically proven to affect the DFU (OR = 8.5; 95% CI: 2.1 - 33.5). Meanwhile,
other variables do not prove to be statistically affect the DFU (the sensory neuropathy, the motor
neuropathy,autonomic neuropathy, sex, foot care , history of DM, age and blood glucose levels). 54% the
incidence of DFU influenced by factors studied, while 46% is influenced by other factors. It is reccommended
that for a nurse to provide health education foot care, particularly preventive measures in clients who have a
history of previous ulcer.
Keywords: risk factors, diabetic foot ulcer
Introduction
Nowadays diabetes mellitus (DM) became one of the chronic diseases worldwide wich
prevalence increasing every year. This condition can occur due to sedentary lifestyle.
According the IDF atlas of 2013, the number of diabetic patients in the world has reached
382 million people, and its prevalence is expected to rise 55% to 592 million people by the
year 2035. Indonesia ranks seventh after China, India, USA, Brazil, Russia and Mexico to 10
major countries of DM patients with age 20-79 years (IDF, 2013).
If DM is not well handled, it will lead to various complications, both macrovascular and
microvascular. One complication in diabetic patients are diabetic foot ulcers. The injuries and
other problems in the feet is a major cause of morbidity, disabilit, mortality and if not
handled properly will caused an amputation.
The prevalence of foot ulcers vary in some populations. Neuropathy, deformity, high plantar
foot pressure, poor glucose control, duration of diabetes and age men are more at risk for
diabetic ulcers (Frykberg, 2002). Neuropathy will inhibit signal, stimulation or disruption of
communication in the body that allows individuals are not aware of the dangers on foot.
Diabetic foot neuropathy may experience sensory, motor and autonomic (Soegondo,
Soewondo & Subekti, 2013). Muller et al (2002) also pointed out that 23% of patients with
ulcers also had a history of ulcers or previous amputations.
The risk of diabetic ulcers in the elderly due to a decrease in the physiological functions of
the body due to aging processes which resulted in a decrease in secretion or insulin resistance
that affects the body's ability to control blood glucose levels. Particularly diabetic ulcers
occur in diabetic patients with ≥ 10 years of age due to uncontrolled glucose levels that
enable the emergence of microvascular and macrovascular complications (Hastuti, 2008).
Another factor affecting the incidence of diabetic ulcers are maladaptive behavior that
includes less obedient in doing injury prevention, testing and treatment feet (Lypsky et al,
2004). Foot care is one of the primary prevention efforts in the management of diabetic foot
ulcers which aims to prevent injury. This foot care that includes; I check my feet, cut nails
properly, check the proper footwear and memebersihkan even check the inside of shoes
before use.
The nurse as health care team is responsible for being able to doing early detection the risk
factors so the incidence of diabetic ulcers diabetic ulcers or amputations can be prevented.
Design
This research is case control design. The independent variable of this research consisted of
several risk factors ; gender, age, duration of diagnosed diabetes, blood glucose control,
previous ulcer history, sensory neuropathy, motor neuropathy, autonomic neuropathy and
foot care. The dependent variable is the incidence of diabetic foot ulcers. These samples
included 80, consisting of 40 control group and 40 groups of cases. In the case group, the
inclusion criteria are DM patients who experience diabetic foot ulcers in the SeptemberOctober 2015, willing to become respondents.. In control group the inclusion criteria are :
DM patients who did not have diabetic foot ulcers in the September-October 2015 and
willing to become respondents. The exclusion criteria for both case and control group are
patients who experienced a below knee amputation and loss of consciousness
The study was conducted at the Outpatient Interna Diabetic Centre and Outpatient Clinic
Surgery RSUP Sanglah Denpasar.
Result
1) Characteristic of respondent
The majority of respondents are male, aged